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Billing code 27616: Tumor resectionMedicare rate & RVUs

Reports radical removal of a soft-tissue tumor in the leg or ankle area when the tumor measures 5 cm or greater.

CMS RVU26DEffective Oct 1, 2026109 payment localities323 Medicare services in 2024

Medicare pays $1,158.68 for 27616 nationally in a facility.

Medicare rate · 27616

Tumor resection

Swap in your local Medicare rate.

Work RVUs
19.14
Total RVUs
34.69
Global days
090

National rate · 2026

$1,158.68

Facility setting, before claim adjustments.

See every locality for 27616 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 27616 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27616 covers

This code describes radical resection of a soft-tissue tumor in the leg or ankle area measuring at least 5 cm. It is used for definitive removal, such as oncologic surgery for a suspected or confirmed soft-tissue malignancy, rather than a diagnostic sample or a routine limited excision. Orthopedic oncologists and other surgeons may perform the operation in a hospital or outpatient surgical setting, depending on the patient and procedure.

Choose the code based on the tumor’s size and the radical extent of the operation; document the site, tumor dimensions, and operative approach. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity, and co-surgeon payment requires supporting documentation; team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 27616 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27616 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,050.72
Alaska*Unavailable$1,440.49
ArizonaUnavailable$1,126.84
ArkansasUnavailable$1,037.53
AtlantaUnavailable$1,194.67
AustinUnavailable$1,166.12
BakersfieldUnavailable$1,152.85
Baltimore/Surr. CntysUnavailable$1,229.66
BeaumontUnavailable$1,114.58
BrazoriaUnavailable$1,129.73

27616 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27616 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27616 rate is calculated

Each of 27616’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 27616

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 19.14Practice expense 11.38Malpractice 4.17

34.6900 adjusted RVUs×$33.4009 conversion factor=$1,158.68

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27616

27616 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27616

Tumor resection

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27616

Tumor resection

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27616 without 50 · national facility

$1,158.68

Tumor resection

27616-50 · Bilateral: 150%

$1,738.02

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

27616 compared with similar codes

Compare codes

27616 vs 27615 vs 27634 vs 27613: national Medicare rates

Swap in your local Medicare rate.

  • 27616
    Tumor resection · 19.14 wRVU
    —
  • 27615
    Tumor resection · 15.33 wRVU
    —
  • 27634
    Soft-tissue excision · 9.88 wRVU
    —
  • 27613
    Soft-tissue biopsy · 2.16 wRVU
    $260.86

How to choose

27615Tumor resection
This is the size sibling for radical resection: 27616 applies at 5 cm or greater; 27615 applies below 5 cm.
27634Soft-tissue excision
27634 describes excision of a deep or subfascial tumor in the leg or ankle area. 27616 is for radical tumor resection at the 5 cm-or-greater threshold.
27613Soft-tissue biopsy
27613 is for diagnostic soft-tissue biopsy in the lower-leg or ankle area. 27616 is for definitive radical removal of a qualifying tumor.

Codes related to 27616

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 27616
CodeHow it relatesNational office range
Same family
27615Tumor resectionRadical resection of a leg or ankle soft-tissue tumor smaller than 5 cm.No office rate
Used instead
27634Soft-tissue excisionDeep or subfascial leg or ankle tumor excision, selected according to the procedure performed.No office rate
27613Soft-tissue biopsyBiopsy of lower-leg or ankle soft tissue for diagnostic sampling rather than definitive resection.$230.46–$342.22
27614Soft-tissue biopsyDeep soft-tissue biopsy in the lower-leg or ankle area, rather than radical tumor removal.$540.28–$789.35

27616 billing questions

How is this distinguished from 27615?

Both describe radical resection of a leg or ankle soft-tissue tumor. Use 27616 for a tumor 5 cm or greater and 27615 for one smaller than 5 cm.

How does this differ from 27634?

27616 describes radical tumor resection at the 5 cm threshold. 27634 describes excision of a deep or subfascial leg or ankle tumor; select based on the operation performed and the applicable code definition.

Can a biopsy be reported with the resection?

This code represents definitive tumor removal, not diagnostic sampling. Document any separately performed diagnostic procedure and assess whether it is separately reportable for that encounter.

What documentation supports reporting 27616?

Record the tumor’s leg or ankle location, its dimensions establishing the 5 cm-or-greater threshold, and the operative details supporting radical resection.

What is included in the global period?

The 90-day global period includes the preoperative visit on the day before surgery and 90 days of related postoperative care.

When can an assistant or co-surgeon be paid?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 27616PPRRVU2026_Oct_nonQPP.csv, line 2,975 (RVU26D)

Open CMS sourceHow we calculate rates

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